Mr Russell Kevin Broxson Jr, FNP BC is a medicare enrolled "Nurse Practitioner - Family" in Jay, Florida. His current practice location is
14114 Alabama St, Jay, Florida. You can reach out to his office (for appointments etc.) via phone at
(850) 675-8000.
Mr Russell Kevin Broxson Jr is licensed to practice in Florida (license number 11031992) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1295587293.
Provider's Profile
| Full Name | Mr Russell Kevin Broxson Jr |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Family |
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| Location | 14114 Alabama St, Jay, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1295587293
- Provider Enumeration Date: 04/03/2024
- Last Update Date: 04/16/2024
Medicare PECOS Information:
- PECOS PAC ID: 5698212199
- Enrollment ID: I20241115002240
Medical Identifiers
Medical identifiers for Mr Russell Kevin Broxson Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1295587293 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 11031992 (Florida) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Russell Kevin Broxson Jr allows following entities to bill medicare on his behalf.
| Entity Name | Jay Hospital Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1518071562
PECOS PAC ID: 3577466325
Enrollment ID: O20040129000235 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Russell Kevin Broxson Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mr Russell Kevin Broxson Jr, FNP BC
5228 Medicine Bow St,
Milton, FL 32570-8149
Ph: (850) 449-4801 | Mr Russell Kevin Broxson Jr, FNP BC
14114 Alabama St,
Jay, FL 32565-1219
Ph: (850) 675-8000 |
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